Prevalence of Conventional Antipsychotic Induced Movement Disordrs and Associated Factors Among Psychotic Patients Treated At Amanuel Mental Specialized Hospital,

Abstract

Background: Neuroleptic-induced movement disorders constitute a worldwide problem in the treatment of schizophrenia because of the limited affordability of atypical antipsychotic drugs. The observable features of acute Parkinsonism; such as limb stiffness and slowness of movement are a social and functional handicap. The same is true of the restless movements and agitation associated with acute akathisia. Tardive dyskinesia, on the other hand is a permanent condition that affects quality of life. However, the prevalence of Neuroleptic-induced movement disorders and their associated factors have not been studied in psychotic patients in Ethiopia.

Objective: To determine the prevalence of conventional antipsychotic induced movement disorders and associated factors among psychotic patients at Amanuel mental specialized Hospital.

Method:  Hospital based cross-sectional study was conducted by using established clinical rating scales to identify cases of conventional antipsychotic-induced movement disorders in Amanuel mental specialized Hospital samples of 377 psychotic outpatients. Systematic random sampling method was employed to select subjects. Logistic regression was used for comparison of the subjects with and without Neuroleptic-induced movement disorders.

Results: Neuroleptic-induced movement disorders according to the clinical rating scales were found in: 175(46.4%) had neuroleptic-induced Parkinsonism, 108(28.6%) had neuroleptic-induced Akathisia and 45(11.9%) had neuroleptic-induced tardive dyskinesia.  Khat use AOR=1.93, 95%CI: 1.01-3.66 was factors remained to be associated with the presence of NIA.  Alcohol use AOR = 3.25, 95%CI: 1.04-10.16 was associated with TD. Being on chlorpromazine equivalent dose range of >=400mg/day AOR =4.32, 95%CI: 2.25-8.30, AOR = 3.677, 95%CI: 1.807-7.482, AOR=4.157, 95%CI: 1.165-14.834 were associated with Parkinsonism, Akathisia and TD respectively.

Conclusions:  Many patients with psychotic disorders suffered from a conventional antipsychotic -induced movement disorder. Khat, alcohol and high dose of drugs were found to be associated with conventional antipsychotic Induced movement disorders.

Recommendation: Treatment guideline should be developed to reduce these devastating side effects by careful choice of treatment.